Along with Dr. Ricardo Izurieta, an associate professor of global health who completed his medical degree in Ecuador, Reina has undertaken a research study focused on HIV in the Esmeraldas region of Ecuador, where nearly half the population is made up of African descendants.

“African descendants are an important but sometimes neglected population subgroup, and local leaders, like Dr. Diogenes Cuero Caicedo [a lawyer], have made significant efforts to rescue the cultural identity and improve life among them,” noted Reina.

The region is thought to have such a high proportion of people
with African heritage because of a Spanish shipwreck that occurred around the
area during the time of the slave trade. Through the chaos of the event, the
slaves were able to free themselves and ended up inhabiting Ecuador.

“Interestingly, the slaves seemed to have developed relationships with local indigenous populations and established La República de los Zambos, probably the first group in the Americas to operate as an entity independent of the Spanish crown,” said Reina.

Esmeraldas, a region in Ecuador with a high density of African descendants.(Photo courtesy of Reina)

The scope of his research in the region involves working with other teams to discover important determinants of HIV and HIV-related behaviors within the population.

“[We have found] that the determinants vary according to different sub-populations,” said Reina. “For instance, among men who have sex with men, we found that HIV/syphilis co-infection and syphilis mono-infection were more common among participants who were older, those who had multiple partners, or those who had been forced to have sex in the 30 days prior to the survey.”

With these determinants in mind, Reina works to ensure that
his research helps to contribute to the HIV knowledge base of certain leaders
and officials within Ecuador, with hopes that they can help solve the epidemic
in this region.

“Depending on the specific needs and scale [of the epidemic],
either the local district or zone representatives will be involved. But if a
national scale-up is required, then the Ministry of Health will be involved,”
said Reina.

He hopes this type of research will help develop relationships with officials and lay the foundation for future decisions that benefit those at risk for HIV infection.

“At the moment, our dissemination efforts are focused on publishing papers and providing results at national and international conferences where there is the potential to network with decision makers,” said Reina.